JP6640115B2 - Sacral fixation system - Google Patents

Description

(Cross-reference of related applications)
This application claims the benefit of US Patent Application No. 61 / 991,829, filed May 12, 2014, and further claims the benefit of US Patent Application No. 61 / 992,105, filed May 12, 2014. The disclosure of each of which is incorporated herein by reference as if set forth in its entirety.

  Implants are known for securing bone parts to one another to promote bone healing. For example, referring to FIG. 1, when the sacrum is fractured, a conventional implant system 20, such as the interiliac bar 22, may support the first and second iliacs 24 and 26 with respect to each other. And thereby stabilize the sacral fracture. The iliac bar 22 has a thickness sufficient to absorb the stresses experienced during use. While conventional interiliac bars 22 are suitable for their intended purpose, they have drawbacks because the surgeon cuts the end after placing the bar in place. Due to the thickness of the iliac bar 22, the surgical procedure typically involves a relatively large surgical field. Thus, the surgical procedure can be invasive, using a large incision to access the interiliac bar and cut it with a suitably strong cutting instrument.

  In a first aspect of the present disclosure, a sacral fixation implant has a first implant section having a first shaft sized to be inserted through a first bone location that may be defined by a first iliac bone. including. The first implant section defines a first proximal end and a first distal end opposite the first proximal end. A first abutment section extends out of the first shaft and is configured to abut the first bone location to prevent further insertion through the first bone location. A surface can be defined. The first implant section may further define a first channel extending through the first shaft from a first proximal end to a first distal end. The sacral fixation system can further include a second implant section having a second shaft sized to be inserted through a second bone location that can be defined by a second iliac bone. The second implant section defines a second proximal end and a second distal end opposite the second proximal end. A second abutment section extends out of the second shaft and is configured to abut the second bone location to prevent further insertion through the second bone location. A surface can be defined. At least the second distal end may be sized to be received in the first channel at a location between the first bone location and the second bone location. The sacral fixation system includes at least one locking member configured to secure the first and second implant sections against movement of the first and second implant sections away from each other. Further, the at least one locking member may be disconnected from each of the first and second implant sections to connect the first and second shafts from a first proximal end to a second proximal end. It does not extend through.

The foregoing summary, as well as the following detailed description of embodiments of the present application, will be better understood when read in conjunction with the appended drawings. For the purpose of illustrating the methods, implants and systems of the present application, preferred embodiments are shown in the drawings. However, it is to be understood that this application is not limited to those precise methods, implants and systems shown. The drawings are as follows.
1 is a posterior view of a human sacral region and a conventional sacral implant system secured to the sacral region. 1 is a front view of a human sacrum showing a sacral implant system constructed according to an embodiment of the present disclosure secured to first and second iliac bones. FIG. 3 is a perspective view of a portion of a sacral fixation implant configured to be included in the sacral implant system illustrated in FIG. First and second locking members configured to secure the section to the guidewire. FIG. 3B is a perspective view of the distal end of the first and second implant sections of the implant illustrated in FIG. 3A. FIG. 3B is a perspective view of a portion of the first implant section illustrated in FIG. 3A, illustrating attachment of a first locking member. FIG. 3B is a perspective view of a portion of a sacral fixation implant similar to the sacral fixation implant illustrated in FIG. 3A, but including a locking member constructed according to an alternative embodiment. FIG. 4B is a perspective view of a portion of the first implant section, which is part of the first implant section illustrated in FIG. 4A, but illustrating the attachment of a locking member constructed according to an alternative embodiment. FIG. 3 is a perspective view of a portion of another sacral fixation implant configured to be included in the sacral fixation implant illustrated in FIG. 2, wherein the sacral fixation implant includes first and second implant sections; A securing member configured to secure the two implant sections to each other. FIG. 5B is an exploded perspective view of the sacral fixation implant illustrated in FIG. 5A. FIG. 5B is a perspective view of the fixing member illustrated in FIG. 5A. FIG. 5B is a perspective view of the area of the sacral fixation implant illustrated in FIG. 5A, whereby the first implant section receives the second implant section. FIG. 3 is a perspective view of a sacral fixation implant configured to be included in the sacral fixation system illustrated in FIG. 2, wherein the sacral fixation implant was constructed according to another alternative embodiment. FIG. 6B is a side view of the contact member of the sacral fixation implant illustrated in FIG. 6A. 1 is a perspective view of a targeting device constructed according to one embodiment. FIG. 7B is an enlarged perspective view of a cutting tip of the targeting device illustrated in FIG. 7A. FIG. 4 is an end elevation view showing the targeting device aligned with the imaging source.

  Referring generally to FIGS. 2-7C, a sacral fixation system 30 constructed according to one embodiment includes one or two configured to be implanted into first and second bone locations 31a and 31b of a patient's body. Including the above bone fixation implant. According to certain embodiments, the sacral fixation system 30 is configured to align a corresponding guidewire for insertion into or through corresponding first and second bone locations of the bone fixation implant. It may further include a targeting device 34 configured. Each of the bone fixation implants 32 can include a first implant section 36, which can include a first shaft 40. Each of the bone fixation implants 32 can further include a second implant section 38, which can include a second shaft. According to certain embodiments, the sacral fixation system may include a guidewire 44. The guide wire 44 guides the first and second implant sections 36 and 38 to the corresponding first and second bone locations 31a and 31b, respectively. 38 are configured to be received by each of them. According to one particular example, the guidewire 44 may be configured to prevent the first and second implants 36 and 38 from moving away from each other, such that each of the first and second implant sections 36 and 38 respectively. It is further configured to be fixed to. According to another example, a guidewire 44 is secured to each of the first and second implant sections 36 and 38 to prevent the first and second implants 36 and 38 from moving relative to each other. It is further configured as follows. Guidewire 44 may be configured as Kirsiner's steel wire, or any suitable alternative guidewire as desired.

  In use, the guidewire 44 can be driven through the first and second bone locations 31a and 31b. The first implant section 36 is inserted over the guidewire 44 and is driven through the first bone position 31a. In one particular example, the first implant section 36 is configured to drill a borehole through the first bone location 31a. Alternatively, the borehole may be pre-drilled. The second implant section 38 is inserted over the guidewire 44 and is driven through the second bone location 31b. In one particular example, the second implant section 36 is configured to drill a borehole through the second bone location 31b. Alternatively, the borehole may be pre-drilled. The second implant section 38 is driven through the second bone location 31b until the distal end of the second implant section 38 is received by the first implant section 36. The bone fixation implant 32 is configured to secure the first and second implant sections 36 and 38 against translation of the first and second implant sections 36 and 38 away from each other. , And a fixing mechanism 46.

  The first bone location 31a may be defined, for example, by a first iliac 33a, and the second bone location 31b is spaced from the first iliac 33a by a sacrum S, and thus opposite the iliac S May be defined by a second iliac 33b disposed on the side. Accordingly, each of the bone fixation implants 32 can be referred to as a sacral fixation implant. For example, a first iliac 33a may be defined by a left hip, and a second iliac 33b may be defined by a right hip. Alternatively, first bone location 31a may be defined by second iliac 33b, and second bone location 31b may be defined by first iliac 33a. The bone fixation implant 32 is configured to be implanted according to a minimally invasive surgery (MIS) technique, where a small incision is sufficient to facilitate implantation of the implant segment and fixation of the implant segment at the first and second bone locations. It will be understood that The sacral fixation system 20 and its components can be manufactured from any suitable material, for example, a metal such as titanium or steel, or a polymer such as polyetheretherketone (PEEK) or reinforced PEEK. In one embodiment, the sacral fixation system 30 can include at least one implant 32 that extends through the first and second iliacs 33a and 33b without passing through the sacrum S. Alternatively or additionally, sacral fixation system 30 may include at least one implant extending through both first and second iliacs 33a and 33b and further extending through sacrum S.

  Referring now to FIGS. 2-4B, the first implant section 36 can include a first shaft 40 sized to be inserted through the first bone location 31a. The first shaft 40, and thus the first implant section 36, can define a first proximal end 40a and a first distal end 40b opposite the first proximal end 40a. . When the implant section 36 is implanted in the first bone location 31a, the first proximal end 40a can define an outer end and the first distal end 40b can define an inner end. it can. The first shaft 40 may extend along a first central axis between a first proximal end 40a and a first distal end 40b. At least a portion up to the whole of the first central axis may be linear. The first shaft 40 may be cylindrical or may define any suitable alternative shape as desired.

  The first implant section 36 can include a first abutment surface 52 extending out of the first shaft 40. For example, the first abutment surface 52 may be disposed proximate the first proximal end 40a. In one example, the first implant section 36 can include a first abutment member 54 extending out of the first shaft 40. The first abutment member 54 can be raised with respect to the first shaft 40 in a direction away from the first central axis, so that the first abutment member 54 has a first abutment surface. Define 52. In this regard, it should be understood that the first abutment member 54 may be integral with the first shaft 40. Alternatively, the first abutment member 54 and the corresponding first abutment surface 52 can be separated from the first shaft 40 and mounted on the first shaft 40. For example, first abutment member 54 is in the form of a washer, clip, or other similar structure configured to be supported by first shaft 40 to define a first abutment surface. obtain. For example, the washer may be configured as washer 254, described in more detail below with respect to FIG.

  The first implant section 36 can define a substantially constant first outer cross-sectional dimension from the distal end 40b to the first abutment surface 52. The first outer cross-sectional dimension extends across a first central axis, and the first outer cross-sectional dimension may be a diameter or any suitable alternative cross-sectional dimension as desired. First implant section 36 may be annular. For example, the first implant section 36 can further define a first channel 56 extending through the first shaft 40 from a first proximal end 40a to a first distal end 40b. The first channel 56 can extend along a first central axis. Thus, the first shaft 40 can define an inner surface 47a that defines the first channel 56 and an outer surface 47b opposite the inner surface 47a. First channel 56 is sized to receive guidewire 44.

  In one example, and with reference to FIG. 3B, the first distal end 40b can define an annular tip 43, which can be serrated, such that the serrated portion has a first proximal end 40a. To a first distal end 40b in a first direction. The annular tip defines a cutting surface 45 configured to drill a hole at the first bone location 31a. For example, the cutting surface 45 can be applied to the first bone location 31a, and the first shaft 40 can rotate about a first central axis, so that the sawtooth cutting surface 45 A boring hole is made at the first bone position 31a. Therefore, the first shaft 40 can be referred to as a self-drilling type. As described above with respect to FIG. 2, the bone fixation implant 32 may be configured to extend through the sacrum S if desired. Thus, for example, if the implant 32 is to extend through the sacrum S, the cutting surface 45 can drill a hole in the sacrum after being driven through the first bone location 31a. Alternatively, as described in more detail below, prior to insertion of the first shaft 40 through the first bone location 31a, a cutting instrument can pierce the first bone location 31a. The cutting instrument can further drill a hole in the sacrum S if desired. Thus, it should be understood that the annular tip can alternatively define a smooth surface if desired.

  Referring now to FIGS. 2-4B, the second implant section 38 can include a second shaft 42 sized to be inserted through the second bone location 31b. The second shaft 42, and thus the second implant section 38, can define a second proximal end 42a and a second distal end 42b opposite the second proximal end 42a. . When the second implant section 38 is implanted in the second bone location 31b, the second proximal end 42a can define an outer end and the second distal end 42b defines an inner end. can do. The second shaft 42 may extend along a second central axis between a second proximal end 42a and a second distal end 42b. At least a portion up to the whole of the second central axis may be linear. The second shaft 42 may be cylindrical or may define any suitable alternative shape as desired. At least a portion of second shaft 42 may be sized to be received in first channel 56. For example, at least the second distal end 42b can define a cross-sectional dimension that is slightly smaller than the cross-sectional dimension of the first channel 56. When the second shaft 42 is received in the first channel 56, the first and second central axes can coincide with each other.

  The second implant section 38 can include a second abutment surface 58 that extends out of the second shaft 42. For example, the second abutment surface 58 may be disposed proximate the second proximal end 42a. In one example, the second implant section 38 can include a second abutment member 60 extending out of the second shaft 42. The second abutment member 60 can be raised with respect to the second shaft 42 in a direction away from the second central axis, so that the second abutment member 60 can be moved to the second abutment surface. Define 58. In this regard, it should be understood that the second abutment member 60 may be integral with the second shaft 42. Alternatively, the second abutment member 60 and the corresponding second abutment surface 58 can be separated from the second shaft 42 and mounted on the second shaft 42. For example, the second abutment member 60 is in the form of a washer, clip, or other similar structure configured to be supported by the second shaft 42 to define a second abutment surface. obtain. For example, the washer may be configured as washer 254, described in more detail below with respect to FIG. The second implant section 38 can define a substantially constant second outer cross-sectional dimension from the second distal end 42b to the second abutment surface 58. The second outer cross-sectional dimension extends across a second central axis, and the second outer cross-sectional dimension may be a diameter, or may be any suitable alternative cross-sectional dimension as desired.

  The second implant section 38 may be annular. For example, the second implant section 38 can further define a second channel 62 that extends through the second shaft 42 from a second proximal end 42a to a second distal end 42b. Thus, the second shaft 42 can define an inner surface 57a that defines the second channel 62 and an outer surface 57b opposite the inner surface 57a. The second channel 62 can extend along a second central axis and can have a cross-sectional dimension that is slightly greater than the cross-sectional dimension of the guidewire 44, such that the second channel 62 It is sized to receive the wire 44. Accordingly, the cross-sectional dimension of the second channel 62 is smaller than the cross-sectional dimension of at least a portion of the first channel 56 that receives the second shaft 42. The first and second cross-sectional dimensions extend across the first and second central axes, respectively, and can define a diameter or any suitable cross-sectional dimension as desired.

  In one example, as illustrated in FIG. 3B, the second distal end 42b can define a second annular tip 53, which can be serrated, such that the serrated is 2 extends in a second direction from the proximal end 42a to the second distal end 42b. Accordingly, the second annular tip 53 defines a second cut surface 55 configured to drill a hole at the second bone location 31b. For example, the second cutting surface 55 can be applied to the second bone position 31b, and the second shaft 42 can rotate around a second central axis, thereby providing a sawtooth cutting surface 55 drills a borehole at the second bone location 31b. Therefore, the second shaft 42 can be referred to as a self-drilling type. As described above with respect to FIG. 2, the bone fixation implant 32 may be configured to extend through the sacrum S if desired. Thus, for example, if the implant 32 is to extend through the sacrum S, the second cut surface 55 can drill a hole in the sacrum after being driven through the second bone position 31b. Alternatively, as will be described in more detail below, prior to insertion of the second shaft 42 through the second bone location 31b, a cutting instrument may pierce the second bone location 31b. Thus, it should be understood that the second annular tip 53 can alternatively define a smooth surface if desired.

  Referring now to FIGS. 2-4B, in operation, the guidewire 44 moves from a first bone location 31a, such as a first iliac 33a, to a second bone location 31b, such as a second iliac 33b. Placed across the sacroiliac joint. Next, the first channel 56 receives the guidewire 44, the first distal end 40b of the first shaft 40 passes through one of the first and second iliacs 33a and 33b, and It is configured to be inserted along the guide wire 44. For example, the first shaft 40 is inserted through the first bone location 31a in a first direction toward the second bone location 31b until the first abutment surface 52 abuts the first bone location 31a. Can be done. When the first shaft 40 is inserted through the first bone location 31a, the first channel 56 receives and advances along the guidewire 44. Accordingly, the first abutment surface 52 is configured to abut the first bone location 31a so as to prevent the first shaft 40 from being further inserted through the first bone location 31a. .

  The second distal end 42b of the second shaft 42 is configured to be inserted through the other of the first and second bone locations 31a and 31b. For example, the second shaft 42 can be inserted through the second bone position 31b in a second direction opposite to the first direction, toward the first bone position 31a, so that at least Second distal end 42b is received within first channel 56 at a location between first and second bone locations 31a and 31b. The second shaft 42 is inserted in the second direction and the second distal end 42b is moved to the first proximal end 40a until the second abutment surface 58 abuts the second bone location 31b. Through the first channel 56. When the second shaft 42 is inserted through the second bone location 31b, for example, the second iliac 33b, the second channel 62 receives the guidewire 44 and proceeds along the guidewire 44. Accordingly, the second abutment surface 58 is configured to abut the second bone location 31b so as to prevent the second shaft 42 from being further inserted through the second bone location 31b. . The first shaft 40 can be advanced through the first bone position 31a before, after or simultaneously with the insertion of the second shaft 42 through the second bone position 31b, whereby , The second shaft is received by the first channel 56. Subsequent further insertion through the first shaft 40, the second shaft 42, or both corresponding first and second bone locations 31a and 31b will cause the second distal end 42b to be in the first channel 56 In the second direction. As mentioned above, the first and second shafts 40 and 42 can extend through the first iliac 33a and the second iliac 33b, respectively, without passing through the sacrum S. Alternatively, one or both of the first and second shafts can further extend through the sacrum S.

  With continued reference to FIGS. 2-4B, as noted above, the locking mechanism 46 may be configured to move the first and second implant sections 36 and 38 away from each other in a first and second direction. The two implant sections 36 and 38 are configured to secure. It should be understood that the mechanical obstruction between the first abutment surface 52 and the first bone location 31a locks the first implant section 36 against translation towards the second implant section 38. . Further, the mechanical obstruction between the second abutment surface 58 and the second bone location 31b secures the second implant section 38 against translation towards the first implant section 36.

  As will be understood from the following description, the securing mechanism 46 is configured to secure the first implant section to the second implant section 38 via screwing. In one example, the locking mechanism prevents the guidewire 44 and at least one of the first and second shafts 40 and 42 from moving away from the other of the first and second shafts 40 and 42. And at least one locking member configured to: Thus, at least one locking member is provided along at least one of the first and second shafts 40 and 42 along the guidewire 44 in a direction from a corresponding distal end to a corresponding proximal end. Moving can be prevented. In certain examples, the at least one locking member comprises a guidewire in which at least one or both of the first and second shafts 40 and 42 are oriented in a direction from a corresponding proximal end to a corresponding distal end. Can be prevented from moving along. Further, it will be appreciated that in certain instances, at least one locking member does not extend through the implant from the first proximal end 40a to the second proximal end 42a. For example, the locking mechanism 46 can include first and second locking members 64 and 66. The first locking member 64 is configured to move the first implant section 36 along the guidewire 44 in at least one direction, for example, in first and second opposing directions, to a first position. The implant section 36 is configured to be secured to a guidewire 44. The second locking member 66 is adapted to move the second implant section 38 along the guide wire 44 in at least one direction, e.g., in first and second opposing directions. Is configured to secure the implant section 38 to the guidewire 44. Thus, it should be understood that the guidewire 44 can be designed to remain permanently implanted in the sacral region. That is, guidewire 44 remains implanted with first and second implant sections 36 and 38 after completion of the surgical procedure. Stated another way, the guidewire 44 can remain implanted as long as the first implant 32 remains implanted.

  As illustrated in FIG. 3C, one or both of the first and second locking members 64 and 66 can be configured as a locking cap 68. Lock cap 68 includes a lock cap body 70 and a channel 72 that extends through lock cap body 70. Channel 72 is sized to receive guidewire 44. For example, the locking cap body 70 includes an inner surface 71a defining a channel 72 and an outer surface 71b opposite the inner surface 71a. Locking cap body 70 further defines at least one flexible wall 74 that defines a portion of channel 72. For example, the inner surface 71 a of the flexible wall 74 defines a channel 72 having an initial cross-sectional dimension that is greater than that of the guidewire 44. The outer surface 71b of the flexible wall 74 may be threaded and may further taper as it extends distally. The flexible wall 74 is configured to compress the guide wire 44 in response to a radial pressing force applied to the flexible wall 74. In one example, the locking cap 68 can further define at least one compression slot 76 that extends radially through the flexible wall 74 so as to be open with respect to the channel 72.

  Referring to FIG. 3C, locking cap 68 is described in association with second proximal end 42a of second shaft 42. It will be appreciated that when the first locking member 64 is configured as a locking cap 68, the locking cap 68 is described herein with respect to the second proximal end 42a of the second shaft 42. It will be appreciated that, similar to those, it can cooperate with the first proximal end 40a of the first shaft 40. Locking cap 68, particularly flexible wall 74, can receive guidewire 44 such that guidewire 44 extends through channel 72. The locking cap 68 can translate along the guidewire 44 in a distal direction toward the second proximal end 42a. Flexible wall 74 is sized to be at least partially received within an opening extending through second proximal end 42a in a second direction. For example, the opening may be defined by a second channel 62 extending through the second shaft 42 from a proximal end 42a to a distal end 42b. The first shaft 40 also includes an opening extending through the first proximal end 40a along a first direction. The opening may be defined, for example, by a first channel 56 extending through the first shaft 40 from a first proximal end 40a to a first distal end 40b. Thus, the inner surface 57a that defines the second channel 62 can further define an opening. The inner surface 57a at the opening is configured to exert a compressive force on the flexible wall 74 when the locking cap is inserted into the opening. Thus, the compression force applied to inner surface 57a causes flexible wall 74 to compress against guidewire 44 and cause locking cap 68 to be attached to the guidewire.

  It will be appreciated that the flexible wall 74 may be externally threaded and the inner surface 57a may be similarly threaded. Thus, when the locking cap 68 is translated along the guidewire 44 to a position where the flexible wall 74 contacts the second shaft 42, the locking cap 68 It can rotate about the guidewire 44 relative to the second shaft 42 so as to screw together. The flexible wall 74 is tapered in the second direction so that when the locking cap 68 is advanced within the opening of the proximal end 42a, the inner surface 57a will 74 is pressed against the guidewire 44. It should be appreciated that, alternatively or additionally, inner surface 57a may be tapered in a second direction. When the first and second locking members 64 and 66 are configured as the locking caps 68 for screwing with the corresponding shafts 40 or 42, the locking caps 68 are compressed. Without applying force to the shafts 40 and 42, the first and second shafts 40 and 42 are secured to the guidewire 44, which secures the first and second iliacs 33a and 33b against each other. . Thus, when the sacrum S (see FIG. 2) has a fracture, the fracture can be reduced, for example, with reduction forceps, or any suitable alternative structure, and the threaded locking cap 68 can be used to reduce the fracture. The first and second shafts 40 and 42 can be secured to a guidewire 44 to maintain the reduced configuration and thereby promote bone healing. Further, the locking cap 68 can be moved in both directions from the second distal end 42b toward the second proximal end 42a and from the second proximal end 42a toward the second distal end 42b. , May be configured to prevent the second implant section 38 from moving along the guidewire 44.

  The first locking member 64, specifically the locking cap 68, secures the first implant section 36 to the guidewire 44 and the guidewire 44 is then secured to the second implant section 38. , Can be configured to screw onto the first implant section 36, so that the securing mechanism 46 can be said to secure the first implant section 36 to the second implant section 38 via screwing. Further, a second locking member 66, specifically a locking cap 68, secures the second implant section 38 to the guidewire 44, which in turn is secured to the first implant section 36. As such, the locking mechanism 46 can be configured to screw onto the second implant section 38 via screwing because it can be configured to screw onto the second implant section 38.

  2 and 4A-4B, it should be understood that at least one of the first and second locking members 64 and 66 can be configured as a locking nut 78. For example, the first locking member 64 can be configured as a locking cap 68 and the second locking member 66 can be configured as a locking nut 78. Alternatively, the first locking member 64 can be configured as a locking nut 78 and the second locking member 66 can be configured as a locking cap 68. Alternatively or additionally, each of the first and second locking members 64 and 66 can be configured as a corresponding locking nut 78. Alternatively or additionally, each of the first and second locking members 64 and 66 may be configured as a corresponding locking cap 68.

  Lock nut 78 is described in connection with first proximal end 40a of first shaft 40. It will be appreciated that when the second locking member 66 is configured as a locking nut 78, the locking nut 78 is described herein with respect to the first proximal end 40a of the first shaft 40. It will be appreciated that, similar to those, it can cooperate with the second proximal end 42a of the second shaft 42. Lock nut 78 can define a nut body 80, which has an inner surface 82a defining a channel 84 extending through the nut body 80, and an outer surface 82b opposite the inner surface 82a. . Channel 84 is sized to receive guidewire 44. Inner surface 82 may be threaded. Therefore, it can be said that the locking nut 78 has a female thread. Further, at least a portion of guidewire 44 may be externally threaded. A portion of the guidewire 44 can be disposed proximate to the first proximal end 40a and when the first abutment surface 52 is positioned adjacent to the first bone location 31a. For example, it can extend from a first position spaced from the first proximal end 40a in a second direction region to a second position spaced in a first direction from the proximal end 40a.

  As a result, the lock nut 78 is screwed onto the guide wire 44 and is threaded along the guide wire 44 toward the first shaft 40 until the lock nut 78 abuts the first shaft 40. It is configured to be. For example, lock nut 78 can abut first proximal end 40a. Subsequent rotation of the lock nut 78 about the guide wire 44 while the second abutment surface 58 is in contact with the second bone location 31b will therefore cause the first shaft 40 to move to the second shaft position. Bias in a first direction toward. Thus, when the first abutment surface 52 contacts the first bone location 31a, the compression nut is configured to apply a compression force transmitted to the first and second iliacs 33a and 33b (FIG. 2). Specifically, the first shaft 40 extends through the first iliac 33a such that the first abutment surface 52 contacts the first iliac 33a, and the second shaft 42 A second abutment surface 58 extends through the second iliac 33b to the first shaft 40 until contacting the second iliac 33b. One of the first and second shafts 40 and 42 may move in a direction away from the other of the first and second shafts 40 and 42 in any of the ways described herein. , Can be secured to a guidewire. The lock nut 78 is then advanced along the guide wire until the lock nut 78 exerts a compression force on the other of the first and second shafts 40 and 42, whereby the first and second Is applied to each of the iliac bones 33a and 33b toward the other of the first and second iliac bones 33a and 33b. If the sacrum S has a fracture, this compression is used to promote bone healing. The implant 32 can maintain compression force throughout the bone healing period, thus maintaining fracture reduction and promoting bone healing. As illustrated in FIG. 2, the sacral fixation system 30 can include first and second implants 32, each of which can be constructed in accordance with any of the embodiments described herein, to replace each of the iliac bones. To stabilize each other, in some cases, the sacrum S may be positioned at different locations in the iliac to exert compression. It should be further understood that the securing mechanism 46 includes at least one locking member that does not extend through the first and second shafts from the first proximal end to the second proximal end. For example, at least one locking member may be defined by one or both of locking cap 68 and locking nut 78.

  The first locking member 64, specifically the locking nut 78, secures the first implant section 36 to the guidewire 44 and the guidewire 44 is then secured to the second implant section 38. , Can be configured to screw onto the first implant section 36, so that the securing mechanism 46 can be said to secure the first implant section 36 to the second implant section 38 via screwing. Further, a second locking member 66, specifically a locking nut 78, secures the second implant section 38 to the guidewire 44, which in turn is secured to the first implant section 36. As such, the locking mechanism 46 can be configured to screw onto the second implant section 38 via screwing because it can be configured to screw onto the second implant section 38.

  Although the first and second locking members 64 and 66 are constructed according to one embodiment, the locking members 64 and 66 may be constructed according to any suitable alternative embodiment if desired. For example, either or both of the locking members 64 and 66 may extend through a corresponding one of the implant sections and the guidewire 44, thereby securing the corresponding one of the implant sections to the guidewire 44. It may be configured as a locking pin. As another example, either or both of the locking members 64 and 66 may be driven in a threaded manner through a corresponding one of the implant sections in a direction toward a corresponding central axis and a guidewire 44 may be provided. Can be configured as a set screw. Thus, it will be appreciated that the first and second locking members 44 and 46 may be any suitably constructed locking members, unless otherwise described herein.

  Once the locking members 64 and 66 are secured in place, the guidewire 44 can be severed at a position adjacent and proximal to the locking members 64 and 66. The guidewire 44 has a gauge that is substantially below that of a conventional interiliac bar, so that it is simpler, in contrast to the larger, more robust cutting instrument needed to cut thick interosseous bars. The guide wire 44 can be cut with a simple cutting tool. In this regard, the guidewire 44 assists in securing the first and second implant sections 36 and 38 and for movement in a direction away from and / or toward each other while maintaining the anatomical structure. It will be appreciated that the load is absorbed by the first and second implant sections 36 and 38. The guidewire 44 may thus have a thickness substantially less than that of a conventional interiliac bar. For example, the guidewire can have any thickness, as desired, for example, between 0.5 mm and 3.0 mm.

  Referring now to FIGS. 2 and 5A-5D, at least one of the implants 32 can be constructed according to alternative embodiments. For example, the bone fixation implant 132 can be configured to be implanted in first and second bone locations 31a and 31b of a patient's body. As described above with respect to implant 32, implant 132 shown in FIGS. 5A-5D may be used to compress first and second iliacs 33a and 33b with or without compressing each other. The two iliacs 33a and 33b can be stabilized with respect to movement relative to each other. Bone fixation implant 132 has first and second shafts 40 and 42, respectively, and first and second abutment surfaces 52 and 58, respectively, as described above. Implant sections 36 and 38 may be included. Further, the bone fixation implant can include a fixation mechanism 146, as described above, which in turn has at least one of the first and second shafts 40 and 42 with the first and second shafts. At least one locking member 164 may be configured to prevent translation in a direction away from the other of the second shafts 40 and 42. Further, it will be appreciated that the locking member 164 does not extend through the implant from the first proximal end 40a to the second proximal end 42a.

  As shown in FIGS. 5A-5D, locking member 164 is configured as a securing member 186 configured to secure first shaft 40 to second shaft 42 against movement away from each other. be able to. The fixing member 186 has a fixing head 188 and a fixing shaft 190 extending from the fixing head 188. The fixed shaft 190 is inserted through the first proximal end 40a of the first shaft 40 in a first direction, through at least a portion of the first channel 56, and into the second channel 62. It is sized and configured as such. The fixed shaft 190 is configured to attach to the second shaft 42 in the second channel 62, thereby securing the first shaft 40 to the second shaft 42. The fixation member 186 defines a channel 192 that extends through the fixation head 188 and the fixation shaft 190. Channel 192 is sized and configured to receive guidewire 144.

  The securing member 186 defines an inner surface 187a defining a channel 192 and an outer surface 187b opposite the inner surface 187. The outer surface 187b on the fixed shaft 190 can be threaded. Therefore, it can be said that the fixed shaft 190 has an external thread. Similarly, the inner surface 57a of the second shaft 42 may be threaded. Therefore, it can be said that the second shaft 42 has a female thread. Therefore, the fixing member 186 is configured to be screwed with the second shaft 42. Specifically, as noted above, outer surface 187b can be threaded and can be configured to threadably engage inner surface 57a within second channel 62. Accordingly, the fixed shaft 190 can be configured to threadably engage with the second shaft 42 within the second channel 62. For example, the externally threaded surface of the fixed shaft 190 is configured to mate with the threaded inner surface 57a. The securing member 186 can be threaded within the second channel 62 until the securing head 188 abuts the first shaft 40. For example, the fixation member 186 can be threaded within the second channel 62 until the fixation head 188 abuts the first proximal end 40a.

  The locking mechanism 146, specifically the locking member 186, is configured to screw with the second implant section 38 and configured to be locked to the first implant section 36, so that the locking mechanism 146 , It can be said that the first implant section 36 is fixed to the second implant section 38 via screwing. Further, the locking mechanism 146, specifically the locking member 186, can be configured to threadably engage with the first implant section 36, and is further configured to be locked to the second implant section 36. Furthermore, it can be said that the fixing mechanism 146 fixes the first implant section 36 to the second implant section 38 via screwing.

  As shown in FIG. 5D, at least a portion of the second outer surface 57b can define a non-circular cross section along a plane that is perpendicular to the first direction. Thus, the outer surface 57b can define a mating surface 194. Inner surface 47a defines a complementary mating surface that mates with mating surface 194, if desired, to prevent second shaft 42 from rotating within first channel 56 of first shaft 40. be able to. Alternatively or additionally, first implant section 36 defines at least one opening 196, for example, a pair of openings 196 extending through first shaft 40 from outer surface 47b to inner surface 47a. The opening is thus open to the first channel 56. Opening 196 may be located proximal to first distal end 40b, or may be otherwise positioned as desired. The second shaft 42 can be oriented in the first channel 56 such that the opening 196 is disposed adjacent the mating surface 194. First implant section 36 can further define at least one locking pin, such as a pair of locking pins, which are sized and configured to be inserted into aperture 196. Can be configured as a set screw. For example, the aperture 196 can be threaded or otherwise sized to receive a corresponding locking pin, which causes the locking pin to move the second shaft 42 to the second shaft 42. A compression force is applied to the fixed shaft 190 to hold it in the one channel 56.

  As mentioned above, the first shaft 40 can define an opening that extends through the first proximal end 40a in a first direction. The opening may be defined, for example, by a first channel 56 extending through the first shaft 40 from a first proximal end 40a to a first distal end 40b. Thus, the inner surface 47a of the first shaft 40 that defines the second channel 62 can further define an opening. In one example, the fixation head 188 is sized so that the fixation shaft 190 urges the first implant section 36 in the first direction as the fixation shaft 190 advances along the second shaft 42 in the first direction. I have. For example, the fixed head 188 may be tapered in a first direction such that when the fixed member 186 moves in a first direction with respect to the first shaft 40, the fixed head abuts the inner surface 47a at the opening. Can be sized to be at least partially accepted by the

  The fixation member 186 can thus be advanced in the first direction through the second channel 62 until the fixation head 188 exerts a compression force on the first shaft 40 in the first direction. Thus, compression is applied to each of the first and second iliacs 33a and 33b toward the other of the first and second iliacs 33a and 33b. If the sacrum S has a fracture, this compression is used to promote bone healing. The implant 132 can maintain compression force throughout the bone healing period, thus maintaining fracture reduction and promoting bone healing.

  In another example, the outer surface 187b of the securing member 186 in the securing head 188 may be threaded, and at least a portion of the inner surface 47a may be threaded. Thus, rotation of the fixation member 186 about the guidewire 44 with respect to the first and second shafts 40 and 42 causes the fixation shaft 190 to move in the second channel 62 in the first direction along the second shaft 42. The fixed head 188 can be screwed into the inner surface 47a of the first shaft 40. Thus, when the sacrum S (see FIG. 2) is fractured, the fracture can be reduced with, for example, reduction forceps, or any suitable alternative structure, and the first and second abutment surfaces 52 and 58 can abut the first and second bone locations 31a and 31b, respectively, and the fixation member 186 can maintain the fracture in its reduced configuration, thereby promoting bone healing. The first and second shafts 40 and 42 can be fixed relative to each other.

  As noted above, the sacral fixation system 30 is configured such that as the first and second implant sections 36 and 38 are advanced therethrough toward the first and second bone locations 31a and 31b, respectively, A guidewire 44 may be included that is received by the first and second channels 56 and 62. The channel 192 of the fixation member 186 may further receive the guidewire 44 as the fixation shaft 190 moves into the first channel 56 and into the second distal end 42b of the second shaft 42. it can. Fixed head 188 compresses first shaft 40 in a first direction to lock first shaft 40 against movement of first shaft 40 away from second shaft 42. be able to. The obstruction between the first abutment surface 52 and the first bone position 31a prevents the first shaft 40 from moving towards the second shaft 42. Further, when the fixed shaft 190 is mounted on the second shaft 42, the second shaft 42 is moved along the fixed shaft 190 toward and away from the first shaft 40, respectively. The parallel movement in both the direction and the first direction is prevented. Alternatively, the fixed head 188 can be screwed onto the first shaft 40. Thus, when the fixed shaft 190 is screwed with the second shaft 42, the fixing member 186 prevents both the first and second shafts 40 and 42 from moving toward and away from each other. I do. The guidewire 44 is then removed from the implant 122 through either the first channel 56, the second channel 62, and the channel of the securing member 186, in either the first direction or the second direction. be able to. Alternatively, the fixation head 188 may be biased to squeeze the guidewire 44 by the inner surface of the first shaft 40 at the first proximal end 40a, as described above with respect to the locking cap 68. A flexible wall can be defined.

  Referring now to FIGS. 2 and 6, at least one of the implants 32 illustrated in FIG. 2 can be constructed in accordance with another alternative embodiment. For example, the bone fixation implant 232 can be configured to stabilize the first and second bone locations 31a and 31b, according to another embodiment. Accordingly, the bone fixation implant 232 may be referred to as a sacral fixation implant.

  The bone fixation implant can include a first implant section 236 and a second implant section 238. The first implant section 236 can include a first shaft 240 sized for insertion through the first bone location 31a. The first shaft 240, and thus the first implant section 236, can define a first proximal end 240a and a first distal end 240b opposite the first proximal end 240a. . When the first implant section 236 is implanted in the first bone location 31a, the first proximal end 240a can define an outer end and the first distal end 240b defines an inner end. can do. The first shaft 240 can extend along a first central axis between a first proximal end 240a and a first distal end 240b. At least a portion up to the whole of the first central axis may be linear. First shaft 240 may be cylindrical or may define any suitable alternative shape as desired.

  The first implant section 236 can include a first abutment surface extending out of the first shaft 240. For example, the first abutment surface may be disposed proximate the first proximal end 240a. In one example, the first implant section 236 can include a first abutment member extending out of the first shaft 240. The first abutment member can be raised relative to the first shaft 240 in a direction away from the first central axis, such that the first abutment member defines a first abutment surface. I do. As described above with respect to FIGS. 3A-4B, the first abutment member may be integral with the first shaft 240. Alternatively, the first abutment member and the corresponding first abutment surface can be disconnected from the first shaft 240 and mounted on the first shaft 240. For example, the first abutment member is in the form of a washer 254 that is sized to receive the first shaft 240 but defines an opening 259 sized smaller than the first proximal end 240a. Can be Thus, the first proximal end 240a is configured to abut the first surface 254a of the washer 254, such that the second surface 254b of the washer 254 opposite the first surface 254a is abutted. Define the surface.

  It is recognized that when the first shaft 240 is inserted through the first bone location 31a, the central axis of the first shaft 240 may not be perpendicular to the outer surface of the first bone location 31a. . Thus, the washer 254 is curved such that the second surface 254b rests against the outer surface of the first bone location 31a while the first surface 254a generally conforms to the first proximal end 240a. Can be For example, a first end of washer 254 can have a first thickness in a first direction, and a second end of washer 254 can have a first thickness in a first direction. It can have a second thickness that exceeds. The first and second ends may be disposed on either side of the opening 259, for example. Thus, the abutment surface 254b can generally correspond to a corresponding bone location. That is, a wider portion of the abutment surface 254b can abut the bone position than a flat surface placed against the bone position. The abutment surface 254b is curved to substantially coincide with one or both of the first and second iliacs 33a and 33b around a hole for receiving the corresponding shaft of the implant section. Please understand that you get. Proximal end 240a can be configured as a screw head with any suitable drive interface 265 that can be configured as a socket or the like. The driving interface 265 can be configured to interface with a driving instrument to drive or otherwise drive the first shaft 240 to rotate about a first central axis. It is configured to receive a torsional force from the driving instrument, which keeps it stable with respect to rotation. When the first proximal end 240a is tightly tightened against the first bone position 31a, the washer 254 rotates so that the proximal end 240a does not rotate in direct contact with the first bone position 31a. The state which does not move in the direction can be maintained. Instead, the proximal end 240a rotates while contacting the washer 254. In this regard, washer 254 secures washer 254 to soft tissue or bone as desired, or adjacent to soft tissue or bone, to help secure washer 254 in position and help stabilize washer 254 against rotation. A fixed aperture configured to receive a suture or other type of tether can be defined.

  The first implant section 236 can further define a first channel 256 that extends through the first shaft 240 from a first proximal end 240a to a first distal end 240b. First channel 256 can extend along a first central axis. Thus, the first shaft 240 can define an inner surface 247a that defines the first channel 256 and an outer surface 247b opposite the inner surface 247a. First channel 256 is sized to receive guidewire 244. At least a portion of the outer surface 247b may be threaded to mate with the second shaft 242, as described in more detail below. The first distal end 240b can define a tip 243, which can be serrated or otherwise define a cutting groove, such that the annular tip includes a first bone A cut surface 245 configured to drill a hole at position 31a is defined. For example, the cutting surface 245 can hit the first bone location 31a, and the first shaft 240 can rotate about a first central axis, such that the cutting surface 245 A boring hole is made at the bone position 31a. Therefore, the first shaft 240 can be referred to as a self-drilling type. As described above with respect to FIG. 2, the bone fixation implant 232 may be configured to extend through the sacrum S if desired. Thus, for example, if the implant 232 is to extend through the sacrum S, it should be understood that the cutting surface 245 can drill a hole in the sacrum S after being driven through the first bone location 31a. Alternatively, the first distal end 240b may be substantially smooth or otherwise not configured to self-drill through the first bone location 31a. Thus, prior to insertion of the first shaft 240 through the first bone location 31a, the drilling tool can pierce the first bone location 31a.

  With continued reference to FIGS. 2-6, the second implant section 238 can include a second shaft 242 sized to be inserted through the second bone location 31b. The second shaft 242, and thus the second implant section 238, can define a second proximal end 242a and a second distal end 242b opposite the second proximal end 242a. . When the second implant section 238 is implanted in the second bone location 31b, the second proximal end 242a can define an outer end and the second distal end 242b defines an inner end. can do. The second shaft 242 can extend along a second central axis between a second proximal end 242a and a second distal end 242b. At least a portion up to the entirety of the second central axis may be linear, and may coincide with the first central axis when the first and second shafts 240 and 242 are fixed to each other. The second shaft 242 may be cylindrical or may define any suitable alternative shape as desired.

  Second implant section 238 may include a second abutment surface extending out of second shaft 242. For example, the second abutment surface can be disposed proximate to the second proximal end 242a. In one example, second implant section 238 can include a second abutment member extending out of second shaft 242. The second abutment member can be raised relative to the second shaft 242 in a direction away from the second central axis, such that the second abutment member defines a second abutment surface. I do. As discussed above with respect to FIGS. 3A-4B, the second abutment member may be integral with the second shaft 242. Alternatively, the second abutment member and the corresponding second abutment surface can be separated from the second shaft 242 and mounted on the second shaft 242. For example, the second abutment member may be in the form of a washer 254, as described above. Thus, the first implant section 236 can include a first washer 254, and the second implant section 238 can include a second washer 254. The second proximal end 242a is configured to abut a first side 254a of a second washer 254, such that the second side 254b of the second washer 254 defines an abutment surface. .

  It is recognized that when the second shaft 242 is inserted through the second bone location 31b, the central axis of the second shaft 242 may not be perpendicular to the outer surface of the second bone location 31b. . Accordingly, the second washer 254 is positioned such that the second side 254b is positioned against the outer surface of the second bone location 31b while the first surface 254a generally matches the second proximal end 242a. , Can be curved. The second proximal end 242a can be configured as a screw head with any suitable drive interface 267, which can be configured as a socket or the like. The second drive interface 267 can be configured to interface with a drive instrument to drive the second shaft 242 to rotate about a central axis or to stably rotate the second shaft 242 with respect to rotation. It is configured to receive a torsional force from a drive that does any of the maintaining. When the first proximal end 240a is tightened tightly against the first bone position 31a, the washer 254 prevents the second proximal end 242a from rotating in direct contact with the first bone position 31a. In addition, it is possible to maintain a state in which it does not move in the rotation direction. In this regard, the second washer 254 may be positioned adjacent to the second washer 254 as desired to help secure the position of the second washer 254 and help stabilize the second washer 254 against rotation. A fixation aperture can be defined that is configured to receive a suture or other type of tether for fixation to soft tissue or bone to be made.

  The second implant section 238 can further define a second channel 262 extending through the second shaft 242 from a second proximal end 242a to a second distal end 242b. The second channel 262 can extend along a second central axis. Accordingly, the second shaft 242 can define a second inner surface 257a that defines a second channel 262, and a second outer surface 257b opposite the inner surface 257a. Second channel 262 is sized to receive guidewire 244. At least a portion of the second inner surface 257a may be threaded to mate with the first outer surface 247b of the first shaft 240, as described in more detail below. The second distal end 242b can define a tip 253, which can be serrated or otherwise define a cutting groove, such that the annular tip is Defines a second cut surface 255 configured to drill a hole at location 31b. For example, the second cutting surface 255 can be applied to the second bone location 31b, and the second shaft 242 can rotate about a second central axis, thereby providing a second cutting surface. 255 drills a borehole at the second bone location 31b. Therefore, the second shaft 242 can be referred to as a self-drilling type. As described above with respect to FIG. 2, the bone fixation implant 232 can be configured to extend through the sacrum S if desired. Thus, for example, if the implant 232 is to extend through the sacrum S, the second cut surface 255 can drill a hole in the sacrum S after being driven through the second bone location 31b. Alternatively, second distal end 242b may be substantially smooth, or may not be otherwise configured to self-drill through first bone location 31a. Thus, prior to insertion of the second shaft 242 through the second bone location 31b, the piercing instrument can pierce the second bone location 31b.

  As mentioned above, the first outer surface 247b of the first shaft 240 can be threaded. Similarly, the second inner surface 257a of the second shaft 242 may be threaded. Thus, at least one of the first and second shafts 240 and 242 rotates relative to the other such that the first shaft 240 is screwed into the second shaft 242 in the second channel 262. be able to. The first shaft 240 can be threadedly advanced within the second channel 262 such that the first and second iliacs 33a and 33b respectively. Compression is applied to the other of the bones 33a and 33b.

  Referring now to FIGS. 2 and 7A-C, the sacral fixation system 30 includes a piercing instrument configured to pierce either or both of the first and second bone locations 31a and 31b. be able to. The sacral fixation system 30 can further include a targeting device 34, which can be configured as an alignment guide 300 configured to guide the guidewire 44 through the first and second bone locations 31a and 31b. The alignment guide 300 can include a support base 302 and an adjustable arm 304. The alignment guide 300 can further include an elongate guide member 306 defining a proximal end 306a along the central axis and a distal end 306b spaced from the proximal end, the elongate guide member comprising the implant described above. It is configured to coincide with the first and second central axes of the section. Alignment guide 300 may define a channel 307 that extends through guide member 306 from a proximal end 306a to a distal end 306b. The central axis of the guide member 306 can define the central axis of the channel 307. The guide member 306 includes a radiopaque marker 308 at the proximal end 306a. For example, radiopaque marker 308 can be configured as an annular ring that receives proximal end 306a. Guide member 306 can further include a radiopaque tip 310 extending from distal end 306b. Channel 307 can extend further through tip 310 and marker 308. Tip 310 may include one or more teeth 311 configured to be implanted in either or both of first and second bone locations 31a and 31b. The guide member 306 may be supported by an arm 304 that is adjustable so as to be adjustable, as will now be described.

  Specifically, it is desirable that the central axis of the guide member 306 is aligned with the first and second bone positions 31a and 31b, and thereby, among the first and second bone positions 31a and 31b. It will be appreciated that boreholes passing through either or both are properly oriented and positioned. Accordingly, guide member 306 is configured to provide an indication on radiation image 312 whether the central axis is aligned with first and second bone positions 31a and 31b. The radiographic image can be, for example, a radiograph. In this regard, a visual inspection of the tip 310 may indicate that the center axis of the guide member 306 is not aligned with the first and second bone positions 31a and 31b, even if the first and second bone positions are not aligned. It is recognized that it may initially appear as aligned with 31a and 31b. The radiopaque marker 308 and the radiopaque tip 310 are disposed at predetermined positions with respect to each other in the radiographic image 312, and the radiopaque marker 308 and the radiopaque tip 310 are aligned with each other. It is configured to indicate that. Thus, when radiopaque marker 308 and radiopaque tip 310 are aligned with each other on radiographic image 312 and channel 307 is aligned with each of first and second bone locations 31a and 31b. First, it can be concluded that the central axis of the guide member 306 is aligned with the first and second bone positions 31a and 31b. For example, the predetermined position between radiopaque marker 308 and radiopaque tip 310 may be concentric. In one example, tip 310 can be disposed concentrically with radiopaque marker 308.

  When the radiopaque marker 308 and the radiopaque tip 310 are not aligned with each other on the radiographic image 312, the guide member 306 causes the radiopaque marker 308 and the radiopaque tip 310 to be aligned with each other. Until it is adjusted. If the radiopaque marker 308 and the radiopaque tip 310 are aligned with each other, but the central axis or channel 307 is not aligned with each of the first and second bone positions 31a and 31b, The guide member 306 is moved until the radiopaque marker 308 and the radiopaque tip 310 are aligned with each other and the central axis or channel 307 is aligned with each of the first and second bone locations 31a and 31b. The position can be adjusted. Next, the teeth 311 may be anchored to either the first or second bone position 31a while the guide member 306 is in the aligned configuration. The guidewire 44 can then be introduced through the channel 307 and through the first and second bone locations 31a and 31b, if desired alone or in combination with the sacrum S. In this regard, the guidewire 44 may include a cutting tip configured to cut through the first and second bone locations 31a and 31b, if desired alone or in combination with the sacrum S. I want to be understood.

  Once the guidewire 44 is in place, guiding the drill along the guidewire to drill holes at the first and second bone locations 31a and 31b, if desired alone or in combination with the sacrum S. Can be. For example, if the maximum outer cross-sectional dimensions of the first and second shafts are substantially the same, the borehole may be drilled in a single drilling operation using the same drill bit, or And if the maximum cross-sectional dimensions of the second shaft and the second shaft are different from each other, the boring holes may be drilled in separate drilling steps using different drill bits. The above process can be repeated to create as many boring holes as needed at the first and second bone locations 31a and 31b. The drill bit is removed, leaving the bone ready for one or more insertions of the bone fixation implant 32. Alternatively and further, as described above, either or both of the first and second implant sections 36 and 38 may be self-piercing.

  The first sacral fracture, particularly if none of the bone fixation implants 32 is configured to cause compression of the first and second iliacs 33a and 33b toward one another, may be used. It may be reduced before one or more insertions. Alternatively or additionally, at least one of the bone fixation members 32 may be configured to provide compression of the first and second iliacs 33a and 33b toward each other, as described above. it can.

  The above description is provided by way of explanation and is not to be construed as limiting the invention. Although various embodiments have been described with reference to the preferred embodiments or preferred methods, it is understood that the terms used in the specification are words of description and illustration rather than terms of limitation. Should. Furthermore, although embodiments have been described herein with reference to specific structures, methods, and embodiments, the present invention is not intended to be limited to the particulars disclosed herein. . For example, it should be understood that structures and methods described in connection with one embodiment are equally applicable to all other embodiments described herein, unless otherwise specified. Those skilled in the relevant art, with the benefit of the teachings herein, will be able to make numerous modifications to the invention described herein, for example, as defined by the appended claims. Changes can be made without departing from the spirit and scope.

(Embodiment)
(1) a sacral fixation system,
A first implant section having a first shaft sized to be inserted through a first bone location, wherein the first implant section has a first proximal end and the first implant section. A first distal end opposite the proximal end and a first abutment surface, the first abutment surface extending out of the first shaft and the first bone location Configured to abut the first bone location so as to prevent further insertion of the first shaft through the first shaft section, wherein the first implant section is configured to move the first implant section from the first proximal end to the first bone section. A first implant section defining a first channel extending through the first shaft to a distal end of the first implant section;
A second implant section having a second shaft sized to be inserted through a second bone location, wherein the second implant section has a second proximal end and the second implant section. A second distal end opposite the proximal end and a second abutment surface, the second abutment surface extending out of the second shaft and the second bone location Configured to abut the second bone location to prevent further insertion of the second shaft through the second bone location, at least the second distal end having the first bone location and a second bone location. A second implant section sized to be received within the first channel at a location between the bone locations of the second implant section;
At least one locking member configured to secure the first and second implant sections against movement of the first and second implant sections away from each other; At least one lock disconnected from each of the first and second implant sections and not extending through the first and second shafts from the first proximal end to the second proximal end; A sacral fixation system comprising:
(2) The sacrum according to embodiment 1, wherein the first contact surface is integral with the first shaft, and the second contact surface is integral with the second shaft. Fixed system.
(3) Embodiment 1 or 2 wherein the first distal end is serrated to define a cut surface configured to drill a boring hole through the first bone location. Sacral fixation system.
(4) Any of embodiments 1-3, wherein the second distal end is serrated to define a cut surface configured to drill a boring hole through the second bone location. A sacral fixation system according to the present invention.
(5) the second implant section defines a second channel extending from the second proximal end to the second distal end, and wherein the sacral fixation system includes the first and second bones; Further comprising a guidewire sized to extend through each of the locations, such that the first and second channels are such that the first and second shafts are respectively the first and second bones. 5. The sacral fixation system of any of embodiments 1-4, wherein the sacral fixation system is configured to receive the guidewire when inserted through a location.

(6) further comprising first and second locking members, wherein the first locking member is configured so that at least the first shaft moves in the second direction and the first shaft Is fixed to the guide wire, and the second locking member is configured to connect the second shaft to the guide wire at least when the second shaft moves in the first direction. The sacral fixation system of any of embodiments 1-5, wherein the sacral fixation system is configured to fix to the sacrum.
(7) At least one of the first and second locking members includes a locking cap having a flexible wall, and the flexible wall applies a compression force applied to the flexible wall. The sacral fusion system of embodiment 6, wherein the sacral fixation system is configured to compress the guidewire in response to
(8) the locking cap is sized to be at least partially received in an opening extending through the corresponding at least one of the first and second proximal ends, whereby 8. The sacral fixation system of embodiment 7, wherein the inner surface defining the opening is configured to apply the compression force to the flexible wall when the locking cap is inserted into the opening. .
(9) An embodiment as in embodiment 8, wherein the outer surface and the inner surface of the flexible wall are threaded and are configured to screw together when the locking cap is inserted into the opening. The sacral fixation system as described.
The sacral fixation system of any of embodiments 7-9, wherein the locking cap comprises at least one compression slot extending through the flexible wall.

(11) The sacral fusion system according to embodiment 9, wherein at least one of the inner surface and the outer surface is tapered.
(12) The sacral fixation system according to any of embodiments 7 to 11, wherein the first and second locking members include first and second locking caps, respectively.
(13) the guide wire is threaded, at least one of the first and second locking members includes a locking nut, the locking nut is female threaded, and the first And abuts a corresponding one of the second shafts, and with respect to the corresponding one of the first and second shafts, the corresponding one of the first and second shafts. 8. The sacral fixation system of embodiment 6 or 7, wherein the sacral fixation system is threadable with the guidewire to apply a force toward one of the first and second shafts.
(14) A first one of the first and second locking members includes the locking cap, and a second one of the first and second locking members is the locking member. 14. The sacral fixation system according to any of embodiments 6-13, comprising a lock nut.
(15) the second implant section defines a second channel extending at least into the second distal end along a direction toward the second proximal end and the at least one lock A member includes a fixation member having a fixation head and a fixation shaft extending from the fixation head, the fixation shaft being mounted on the second shaft within the second channel to the second shaft. 5. The sacral fixation system of any of embodiments 1-4, wherein the sacral fixation system is configured to be inserted through a proximal end.

(16) the second shaft defines an inner surface that defines the second channel, at least a portion of the inner surface is threaded, and at least a portion of the fixed shaft is threaded. 16. The sacral fixation system according to embodiment 15, wherein the fixation shaft is configured to threadably engage the inner surface within the second channel.
17. The sacral fixation system according to claim 16, wherein the fixation head is sized to compress the first implant section when it is threaded with the inner surface.
(18) the second shaft defines an outer surface opposite the inner surface, the outer surface preventing the first and second channels from rotating with respect to each other; 16. The sacral fusion system of embodiment 15, wherein the sacral fixation system defines a mating surface configured to abut a mating surface of the first shaft within a channel.
(19) the first securing member defines an opening that extends through a wall of the first shaft and into the first channel, wherein the opening relatively connects the first and second shafts; 19. The sacral fixation system according to embodiment 18, wherein the sacral fixation system is configured to receive locking pins configured to lock together against rotation.
(20) The first proximal end is threaded, and the fixation head is threaded, such that the fixation head is configured to threadably engage the first proximal end. 20. The sacral fusion system according to any of embodiments 16-19, wherein

(21) the second channel extends from the second proximal end to the second distal end, and the sacral fixation system extends through each of the first and second bone locations. Further comprising a guidewire sized to allow the first and second channels to be inserted when the first and second shafts are inserted through the first and second bone locations, respectively. 21. The sacral fusion system according to any of embodiments 15-20, configured to receive a guidewire.
(22) The fixation member is configured to receive the guidewire when the fixation shaft is inserted through the first proximal end to attach to the second shaft within the second channel. 22. The sacral fixation system according to embodiment 21, wherein the fixation member is cannulated.
(23) the first abutment surface is defined by a washer defining an opening extending therethrough in a first direction, the opening sized to receive the first shaft; Wherein the washer has a first end having a first thickness and a second end having a second thickness greater than the first thickness; 23. The sacral fusion system according to any of embodiments 1 and 3-22, wherein two ends are on opposite sides of the opening.
(24) The second contact surface is defined by a second washer defining an opening extending therethrough in a first direction, and the opening of the second washer is defined by the second washer. A second end of the first washer having a first thickness and a second end having a second thickness greater than the first thickness. 23. An embodiment as in any of embodiments 1 and 3-22 having an end and wherein the first and second ends of the second washer are on opposite sides of the opening of the second washer. Sacral fixation system.
(25) A sacral fixation system,
A first implant section having a first shaft sized to be inserted through a first bone location, wherein the first implant section has a first proximal end and the first implant section. A first distal end opposite the proximal end and a first abutment surface, the first abutment surface extending out of the first shaft and the first bone location Configured to abut the first bone location so as to prevent further insertion of the first shaft through the first shaft section, wherein the first implant section is configured to move the first implant section from the first proximal end to the first bone section. A first implant section defining a first channel extending through the first shaft to a distal end of the first implant section;
A second implant section having a second shaft sized to be inserted through a second bone location, wherein the second implant section has a second proximal end and the second implant section. A second distal end opposite the proximal end and a second abutment surface, the second abutment surface extending out of the second shaft and the second bone location Configured to abut the second bone location to prevent further insertion of the second shaft through the second bone location, at least the second distal end having the first bone location and a second bone location. A second implant section sized to be received within the first channel at a location between the bone locations of the second implant section;
A securing mechanism spaced apart from each of the first and second implant sections, the securing mechanism configured to secure the first implant to the second implant via screwing; A fixation mechanism, wherein the first and second implant sections are secured to each other at least for movement in a direction away from each other.

(26) The fixing mechanism includes a guide wire and first and second locking members, and the first locking member moves at least the first implant section in the second direction. In contrast, the first implant section is configured to secure the first implant section to the guidewire, and the second locking member is configured to move at least the second shaft in the first direction. 26. The sacral fusion system of embodiment 25, wherein the system is configured to secure the second implant section to the guidewire.
(27) At least one of the first and second locking members includes a locking cap having a flexible wall, and the flexible wall applies a compressive force applied to the flexible wall. 27. The sacral fusion system according to embodiment 26, wherein the sacral fusion system is configured to compress the guidewire in response to
(28) the locking cap is sized to be at least partially received within an opening extending through the corresponding at least one of the first and second proximal ends, whereby 28. The sacral fixation system of embodiment 27, wherein the inner surface defining the opening is configured to apply the compression force to the flexible wall when the locking cap is inserted into the opening. .
(29) In the embodiment 28, the outer surface and the inner surface of the flexible wall are threaded and are configured to screw together when the locking cap is inserted into the opening. The sacral fixation system as described.
30. The sacral fusion system according to any of embodiments 27-29, wherein the locking cap comprises at least one compression slot extending through the flexible wall.

(31) The sacral fusion system according to embodiment 29, wherein at least one of the inner surface and the outer surface is tapered.
(32) The sacral fixation system according to any of embodiments 27 to 31, wherein the first and second locking members include first and second locking caps, respectively.
(33) The guide wire is threaded, at least one of the first and second locking members includes a locking nut, the locking nut is female threaded, and the first And abuts a corresponding one of the second shafts, and with respect to the corresponding one of the first and second shafts, the corresponding one of the first and second shafts. 28. The sacral fixation system of embodiment 26 or 27, wherein the sacral fixation system is threadable with the guidewire to apply a force urging one toward the other of the first and second shafts.
(34) the second implant section defines a second channel extending at least into the second distal end along a direction toward the second proximal end, and wherein the securing mechanism comprises a securing mechanism; A fixation member having a head and a fixation shaft extending from the fixation head, wherein the fixation shaft is inserted through the first proximal end for mounting on the second shaft in the second channel. 26. The sacral fusion system according to embodiment 25, wherein the sacral fusion system is configured to:
(35) The second shaft defines an inner surface that defines the second channel, at least a portion of the inner surface is threaded, and at least a portion of the fixed shaft is threaded. 35. The sacral fixation system according to embodiment 34, wherein the fixation shaft is configured to threadably engage the inner surface within the second channel.

36. The sacral fixation system according to embodiment 35, wherein the fixation head is sized to compress the first implant section when it is threaded with the inner surface.
(37) The first proximal end is threaded, and the fixation head is threaded, such that the fixation head is configured to threadably engage the first proximal end. 37. The sacral fusion system according to any of embodiments 34-36, wherein
(38) wherein the second channel extends from the second proximal end to the second distal end, and the sacral fixation system extends through each of the first and second bone locations. Further comprising a guidewire sized to allow the first and second channels to be inserted when the first and second shafts are inserted through the first and second bone locations, respectively. 38. The sacral fusion system according to any of embodiments 34-37, wherein the sacral fusion system is configured to receive a guidewire.
(39) The fixation member is configured to receive the guidewire when the fixation shaft is inserted through the first proximal end to attach to the second shaft within the second channel. 39. The sacral fixation system according to claim 38, wherein the fixation member is cannulated, so that the fixation member is cannulated.
(40) The first abutment surface is defined by a washer defining an opening extending therethrough in a first direction, the opening sized to receive the first shaft. Wherein the washer has a first end having a first thickness and a second end having a second thickness greater than the first thickness; 40. The sacral fusion system according to any of embodiments 25-39, wherein two ends are on opposite sides of the opening.

(41) The second abutment surface is defined by a second washer defining an opening extending therethrough in a first direction, and the opening of the second washer is defined by the second washer. A second end of the first washer having a first thickness and a second end having a second thickness greater than the first thickness. 41. The sacrum according to any of embodiments 25-40, wherein the sacrum has an end and the first and second ends of the second washer are on opposite sides of the opening of the second washer. Fixed system.
(42) A sacral fixation system,
A first implant section having a first shaft sized to be inserted through a first bone location, wherein the first implant section has a first proximal end and the first implant section. A first distal end opposite the proximal end and a first abutment surface, the first abutment surface extending out of the first shaft and the first bone location Configured to abut the first bone location so as to prevent further insertion of the first shaft through the first shaft section, wherein the first implant section is configured to move the first implant section from the first proximal end to the first bone section. A first implant section defining a first channel extending through the first shaft to a distal end of the first implant section;
A second implant section having a second shaft sized to be inserted through a second bone, wherein the second implant section has a second proximal end and the second proximal end. A second distal end opposite the distal end and a second abutment surface, wherein the second abutment surface extends out of the second shaft and through the second bone location The second implant section is configured to abut the second bone location so as to prevent further insertion of the second shaft of the second shaft section at least toward the second proximal end. A second channel extending into a second distal end is defined, wherein at least the second distal end has the first channel at a position between the first bone position and the second bone position. A second implant section sized to be received within the channel of the second implant section;
A fixation member having a fixation head and a fixation shaft extending from the fixation head, wherein the fixation shaft is mounted on the second shaft within the second channel; A fixation member configured to be inserted therethrough.
(43) the second shaft defines an inner surface that defines the second channel, at least a portion of the inner surface is threaded, and at least a portion of the fixed shaft is threaded. 43. The sacral fixation system according to embodiment 42, wherein the fixation shaft is configured to threadably engage the inner surface within the second channel.
44. The sacral fixation system according to embodiment 42 or 43, wherein the fixation head is sized to compress the first implant section when it is threaded with the inner surface.
(45) the first proximal end is threaded, and the fixation head is threaded, such that when the fixation shaft is threaded with the inner surface in the second channel, 44. The sacral fixation system according to embodiment 43, wherein a fixation head is configured to thread with the first proximal end.

(46) the second channel extends from the second proximal end to the second distal end, and the sacral fixation system extends through each of the first and second bone locations. Further comprising a guidewire sized to allow the first and second channels to be inserted when the first and second shafts are inserted through the first and second bone locations, respectively. 46. The sacral fusion system according to any of embodiments 42-45, wherein the sacral fusion system is configured to receive a guidewire.
(47) The fixation member is configured to receive the guidewire when the fixation shaft is inserted through the first proximal end to mount to the second shaft within the second channel. 47. The sacral fixation system according to claim 46, wherein the fixation member is cannulated.
(48) The guidewire, wherein the guide member is detachable through the first channel, the second channel, and the fixing member after the fixing member fixes the first shaft to the second shaft. 48. The sacral fusion system according to aspect 47.
(49) the second shaft defines an outer surface opposite the inner surface, the outer surface preventing the first and second channels from rotating with respect to each other; 43. The sacral fusion system of embodiment 42, wherein the sacral fusion system defines a mating surface configured to abut a mating surface of the first shaft in a channel.
(50) the first securing member defines an opening that extends through the wall of the first shaft and into the first channel, the opening relative to the first and second shafts; 50. The sacral fixation system according to embodiment 49, wherein the sacral fixation system is configured to receive locking pins configured to lock together against rotation.

(51) The first abutment surface is defined by a washer defining an opening extending therethrough in a first direction, the opening sized to receive the first shaft. Wherein the washer has a first end having a first thickness and a second end having a second thickness greater than the first thickness; 51. The sacral fusion system according to any of embodiments 42-50, wherein two ends are on opposite sides of the opening.
(52) the second abutment surface is defined by a second washer defining an opening extending therethrough in a first direction, and the opening of the second washer is defined by the second washer; A second end of the first washer having a first thickness and a second end having a second thickness greater than the first thickness. 52. The sacrum according to any of embodiments 42-51, wherein the sacrum has an end and the first and second ends of the second washer are on opposite sides of the opening of the second washer. Fixed system.
(53) A sacral fixation system,
A first implant section having a first shaft sized to be inserted through a first bone location, wherein the first implant section has a first proximal end and a first opposite the first proximal end. A first implant section defining a distal end of the first implant section;
A second implant section having a second shaft sized to be inserted through a second bone location, wherein the second implant section has a second proximal end and a second opposite the second proximal end. A second implant section defining a distal end of the second implant section and configured to attach to the first implant section.
At least one washer defining an opening extending therethrough in a first direction, wherein the opening defines a raised abutment surface of the first and second shafts. Sized to receive one, the washer has a first end having a first thickness, and a second end having a second thickness greater than the first thickness. A sacral fixation system, wherein the first and second ends comprise at least one washer on each side of the opening.
(54) the washer defines a first surface opposite the abutment surface, the first surface coinciding with the proximal end of the one of the first and second implant sections. 54. The sacral fusion system according to embodiment 53, wherein the sacral fusion system is curved.
(55) further comprising a second washer defining a second opening extending therethrough in each direction, wherein the opening is a second one of the other of the first and second shafts. A first end sized to receive the other one of the first and second shafts to define a raised abutment surface, the second end having a first thickness. And a second end having a second thickness greater than the first thickness, wherein the first and second ends of the second washer are on opposite sides of the opening. 55. The sacral fusion system according to embodiment 53 or 54, wherein

(56) the second washer defines a first surface opposite the second abutment surface, wherein the first surface is the other of the first and second implant sections. 56. The sacral fusion system according to embodiment 55, wherein the sacral fusion system is curved to conform to the proximal end.
(57) the first implant section includes a first channel extending through the first shaft from the first proximal end to the first distal end, and at least partially defining the first channel; And at least a portion of the second shaft is threadably engaged with the threaded inner surface of the first implant section in the first channel. 57. The sacral fusion system according to any of embodiments 53-56, wherein the sacral fusion system defines a configured threaded outer surface.
(58) the first implant section defines a first channel extending through the first shaft from the first proximal end to the first distal end, and at least the second distal end; A distal end sized to be received within the first channel at a location between the first bone location and the second bone location, wherein the sacral fixation system comprises:
A securing mechanism spaced from each of the first and second implant sections, the securing mechanism configured to secure the first implant to the second implant via a screw connection, whereby the first 57. The sacral fusion system according to any of embodiments 53-56, further comprising a securing mechanism, wherein the second implant section and the second implant section are secured to each other at least for movement in a direction away from each other.
(59) the first implant section defines a first channel extending through the first shaft from the first proximal end to the first distal end and at least the second distal end; A distal end sized to be received within the first channel at a location between the first bone location and the second bone location, wherein the sacral fixation system comprises:
At least one locking member configured to secure the first and second implant sections against movement of the first and second implant sections away from each other; The at least one locking member is disconnected from each of the first and second implant sections and passes through the first and second shafts from the first proximal end to the second proximal end. 57. The sacral fusion system according to any of embodiments 53-56, further comprising at least one locking member that is not extended.
(60) the first implant section defines a first channel extending through the first shaft from the first proximal end to the first distal end, and the second implant section; Defines a second channel extending at least into the second distal end toward the second proximal end, wherein at least the second distal end has a first Sacral fixation system sized to be received in the first channel at a location between two bone locations,
A fixed member having a fixed head and a fixed shaft extending from the fixed head, wherein the fixed proximal shaft is mounted to the second shaft within the second channel. 57. The sacral fixation system according to any of embodiments 53-56, wherein the sacral fixation system is configured to be inserted therethrough.

(61) A method for stabilizing a first and a second iliac bone with respect to each other,
Inserting a guidewire through said first and second iliac bones;
Driving a portion of a first implant section through the first iliac along the guidewire in a first direction;
Removing a portion of a second implant section until the second implant section is received within the first implant section at a location between the first and second iliac bones. Driving through the second iliac along the guidewire in a second direction opposite to the first direction;
Attaching at least one locking member to at least one of the first and second implant sections without extending the locking member through each of the first and second implant sections. Fixing the first and second implant sections to each other relative to each other in each of the first and second directions. Including, methods.
(62) After the attaching step, the first contact member of the first implant section contacts the first iliac bone, and the second contact member of the second implant section includes 62. The method according to embodiment 61, wherein the method abuts the second iliac bone.
63. The method according to any of embodiments 61 or 62, wherein the step of attaching comprises securing each of the first and second implant sections to the guidewire.
(64) The step of mounting includes: (1) translating the first locking member along the guidewire in the first direction to a position where the first locking member abuts the first implant section, Securing the first implant section against translation along the guide wire in the second direction; and (2) securing a second locking member to the guide in the second direction. Translating along the wire to a position where it abuts the second implant section, thereby translating the second implant section in the first direction along the guidewire. 63. The method according to any of embodiments 61-63, comprising fixing.
(65) At least one of the first and second locking members includes a locking cap, and the attaching step includes the step of attaching to the corresponding one of the first and second implant sections. 65. The method of embodiment 64, further comprising compressing the locking cap against the guidewire, thereby securing the locking cap to the guidewire.

66. The method of claim 65, wherein the attaching further comprises threading the locking cap with one of the first and second implant sections.
(67) The first and second locking members include first and second locking caps, respectively, and the first and second locking caps are respectively connected to the first and second implant sections. 67. The method of any of embodiments 64-66, wherein abutting causes the first and second implant sections to squeeze the first and second locking caps against the guidewire, respectively. .
(68) At least one of the first and second locking members includes a locking nut, and the attaching includes screwing the locking nut to the guide wire, wherein the locking nut is 67. Any of the embodiments 65-67, comprising advancing the lock nut along the guidewire until it abuts the corresponding one of the first and second implant sections. The described method.
(69) The at least one locking member includes a fixing member, and the attaching includes attaching a fixing shaft of the fixing member to the second implant section, and fixing the fixing head of the fixing member to the second implant section. 64. The method of any of embodiments 61-63, comprising translating the fixation member along the guidewire until contacting a first implant section, wherein the fixation shaft extends from the fixation head. .
(70) The attaching step includes: translating the fixing member along the guide wire in the first direction until the fixing shaft is screwed with the second implant section; 70. The method according to embodiment 69, comprising: advancing the fixation shaft along the second implant section until it contacts the first implant section.

71. The method according to any of embodiments 69 or 70, wherein the step of applying comprises pressing the fixation head against the first implant section.
72. The method according to any of embodiments 69 or 70, wherein the mounting comprises threading the fixation head with the first implant section.
(73) At least one of the first and second implant sections defines a cutting plane, and at least one of the actuating steps cuts through the corresponding iliac bone at the cutting plane. 73. The method according to any of embodiments 61-72, comprising:
(74) Each of the first and second implant sections defines a first and second cut surface, respectively, and at least one of the actuating steps includes removing the first and second iliac bones. 74. The method of embodiment 73, comprising cutting through the first and second cut surfaces, respectively.
(75) Any of embodiments 61-73, further comprising drilling a hole through at least one of the first and second iliac bones before commencing the actuating step. Method.

76. The method according to any of embodiments 61-75, wherein the first actuating step further comprises actuating the first implant segment through the sacrum.
77. The method according to any of embodiments 61-75, wherein the second actuating step comprises further actuating the second implant section through the sacrum.
(78) The method of embodiment 77, wherein the first actuating step further comprises actuating the first implant segment through the sacrum.

Claims (9)

A sacral fixation system,
A first implant section having a first shaft sized to be inserted through a first bone location, wherein the first implant section has a first proximal end and the first implant section. A first distal end opposite the proximal end and a first abutment surface, the first abutment surface extending out of the first shaft and the first bone location Configured to abut the first bone location so as to prevent further insertion of the first shaft through the first shaft section, wherein the first implant section is configured to move the first implant section from the first proximal end to the first bone section. A first implant section defining a first channel extending through the first shaft to a distal end of the first implant section;
A second implant section having a second shaft sized to be inserted through a second bone location, wherein the second implant section has a second proximal end and the second implant section. A second distal end opposite the proximal end, a second channel extending from the second proximal end to the second distal end, and a second abutment surface; A second abutment surface extends out of the second shaft and abuts the second bone location so as to prevent further insertion of the second shaft through the second bone location. Wherein at least the second distal end is sized to be received within the first channel at a location between the first bone location and the second bone location. A second implant segment;
Kirsina steel wire sized to extend through each of the first and second bone locations, wherein the first and second channels are such that the first and second shafts are respectively the A Kirsiner wire configured to receive the Kirsiner wire when inserted through the first and second bone locations;
A first member configured to attach the first shaft to the Kirsiner steel wire to secure the first implant section against movement away from the second implant section; A stop member, disconnected from each of the first and second implant sections, extending through the first and second shafts from the first proximal end to the second proximal end. No, a first locking member;
A second locking member configured to secure the second shaft to the Kirsiner steel wire at least for movement of the second shaft away from the first shaft; ,
The Kirsiner steel wire is threaded, at least one of the first and second locking members includes a locking nut, the locking nut is female threaded, the first and second Abuts a corresponding one of the two shafts, and a corresponding one of the first and second shafts with respect to the corresponding one of the first and second shafts Can be screwed onto the Kirsiner steel wire so as to apply a biasing force toward the other of the first and second shafts, and the other of the first and second locking members Includes a locking cap having a flexible wall, the flexible wall configured to compress the Kirsiner steel wire in response to a compressive force applied to the flexible wall. Sacral fixation system.   The locking cap is sized to be at least partially received within an opening extending through a corresponding at least one of the first and second proximal ends, whereby the locking When the cap is inserted into the opening, the inner surface defining the opening is configured to apply the compression force to the flexible wall, and the outer surface and the inner surface of the flexible wall are threaded. The sacral fixation system of claim 1, wherein the locking cap is configured to screw together when the locking cap is inserted into the opening.   Each of the first and second distal ends is serrated to define a corresponding cutting surface configured to drill a boring hole through the first and second bone locations, respectively. The sacral fixation system of claim 1.   At least one of the first and second abutment surfaces is defined by a washer defining an opening extending therethrough in a first direction, wherein the opening is defined by the first and second openings. The washer is sized to receive a corresponding one of the shafts, the washer having a first end having a first thickness, and a second thickness exceeding the first thickness. The sacral fixation system of claim 1, comprising a second end, wherein the first and second ends are on opposite sides of the opening.   The sacral fixation system according to claim 1, wherein the first abutment surface is integral with the first shaft and the second abutment surface is integral with the second shaft.   The sacral fusion system according to claim 1, wherein the first and second implant sections are made of metal.   The sacral fixation system according to claim 1, wherein the first and second implant sections are constructed from PEEK or reinforced PEEK. At least one of the first and second abutment surfaces is defined by a washer defining an opening extending therethrough in a first direction, wherein the opening is defined by the first and second openings. Sized to receive a corresponding one of the shafts, wherein the at least one of the first and second abutment surfaces is curved to substantially conform to a surface of the iliac bone Oh Ru, sacral fixation system according to claim 1. The first and second abutment surfaces are defined by first and second washers, respectively, each of the first and second washers having an opening extending therethrough in a first direction. defining each opening, are a corresponding one of the previous SL first and second shafts sized to receive respective said first and second abutment surfaces, iliac Ru curved der to substantially match the surface, sacral fixation system according to claim 1.

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